The American Psychiatric Association (APA) publishes the Diagnostic and Statistical Manual of Mental Disorders (the current version is the DSM-IV-Text Revision). The DSM-IV provides definitions and criteria that support a clinician's diagnosis of mental disorders. The DSM-IV provides the generally accepted criteria for defining ADHD (attention-deficit/hyperactivity disorder). ADHD is characterized by DSM-IV criteria in part by presence of certain attention and behavior symptoms. Additionally, the DSM-IV criteria require that the symptoms are not better accounted for by another disorder. As such, ADHD evaluation can be relatively complicated because ADHD-like symptoms are known to be present in other psychiatric disorders, as well as in medical and neurological conditions. For instance, the DSM-IV criteria for depression include psychomotor agitation/restlessness, difficulty making decisions, and difficulty concentrating. The DSM-IV criteria for mania include excessive talking, racing thoughts, distractibility, and psychomotor agitation/restlessness. The DSM-IV criteria for anxiety disorder include concentration difficulties. There are also a number of medical mimics of ADHD including anemia, hearing or vision loss, congenital brain anomalies, mental retardation, medication effects, and head injury (Pearl et al., 2001). Thus, a need exists for an ADHD assessment aid that can effectively or otherwise suitably support separation of attention and behavior symptoms due to ADHD from those due to other conditions.
ADHD behavior rating scales are assessment tools that are recommended in the support of ADHD diagnosis in professional guidelines such as those from the American Academy of Pediatrics (AAP, 2000). The rating scales are designed to assist in the recognition of the attention and behavior symptoms of ADHD as defined by the DSM-IV. However, it is commonly known that attention and behavior symptoms of ADHD are present with other disorders as well as medical and neurological conditions. In addition, many of these common disorders are comorbid in up to 67% of ADHD cases (Cantwell, 1996; Wolraich et al., 1998). Therefore in an ADHD diagnostic evaluation, a clinician faces the challenge of determining whether ADHD is the primary cause of the symptoms, whether the ADHD symptoms are secondary to other diagnoses, or whether ADHD is comorbid with other diagnoses (APA, 1994; Cantwell, 1996; Zametkin and Ernst, 1999). Therefore, a need still exists for an ADHD assessment aid that can effectively or otherwise suitably support separation of attention and behavior symptoms due to ADHD from those due to other conditions.
Professional guidelines have been developed to assist in the implementation of DSM-IV criteria in ADHD diagnosis using evidence such as that from assessment tools. EEG (electroencephalography) is not currently listed in the DSM-IV criteria for ADHD. There is no known mention of using EEG with any guidelines that support the implementation of DSM-IV criteria in ADHD diagnosis such as the guidelines from the American Academy of Pediatrics (AAP, 2000).
At least one conventional technique uses EEG data to diagnose ADHD using an assessment of EEG data collected from a patient. One conventional technique determines a ratio between digitized EEG data in the theta (4-8 Hz) and beta (13-21 Hz) frequency ranges collected from a patient. EEG data is collected from the patient during baseline and at least three attentive behavior tasks. An overall index is calculated for the patient using the ratios determined during the baseline and at least three attentive behavior tasks. The overall index is finally compared to a non-clinical database of normal individuals without ADHD or any neurological disorder to determine the presence and severity of the patient's ADHD. However, the conventional technique is limited to diagnosing ADHD in a patient, and does not address differentiating among ADHD patients diagnosed by a clinician. Furthermore, the conventional technique is a stand-alone diagnostic that does not support the implementation of DSM-IV criteria. Furthermore, the conventional technique does not address the DSM-IV criterion that requires that attention and behavior symptoms in a patient are not better accounted for by another condition. Finally, the conventional technique does not address whether attention and behavior symptoms in a patient are more likely to be due to ADHD or due to another condition. Therefore, a need still exists for an ADHD assessment aid that can effectively or otherwise suitably support separation of attention and behavior symptoms due to ADHD from those due to other conditions.
At least one conventional technique uses EEG data to diagnose disorders of impaired attention using an assessment of EEG data collected from a patient. One conventional technique determines differences between EEG parameters collected from a patient during at least two tasks. An overall index is calculated for the patient using the absolute value of the sum of the EEG differences between tasks by distance. The overall index is finally compared to a non-clinical database of normal individuals without psychiatric disorders to determine the presence of a disorder with impaired attention such as ADHD. However, the conventional technique is limited to diagnosing attention disorders in a patient, and does not address differentiating among ADHD patients diagnosed by a clinician. Furthermore, the conventional technique does not address the DSM-IV criterion that requires that attention and behavior symptoms in a patient are not better accounted for by another condition. Finally, the conventional technique does not address whether attention and behavior symptoms in a patient are more likely to be due to ADHD or due to another condition. Therefore, a need still exists for an ADHD assessment aid that can effectively or otherwise suitably support separation of attention and behavior symptoms due to ADHD from those due to other conditions.